Abstract
Aims
To clarify if prediabetes defined by the International Expert Committee (PrediabetesIEC) and/or the American Diabetes Society (PrediabetesADA) is a risk for incident glomerular hyperfiltration (GH).
Methods
24,524 health examinees without diabetes, chronic kidney disease (CKD), GH and antihypertensive treatment at baseline, and repeated examinations at least twice during a mean of 5.3 years were retrospectively analysed. Diabetes was defined as fasting plasma glucose (FPG) ≥ 7.0 mmol/L and/or HbA1c ≥ 47 mmol/mol, CKD by estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 and/or dipstick-positive proteinuria, and GH by upper 95th eGFR in the Japanese adults. PrediabetesIEC was diagnosed by “HbA1c 42–46 mmol/mol and/or FPG 6.1–6.9 mmol/L”, PrediabetesADA by “HbA1c 39–46 mmol/mol and/or FPG 5.6–6.9 mmol/L”, PrediabetesADA−IEC for the condition met the ADA but not the IEC prediabetes definition, and the ADA-normal glucose regulation (NGRADA) by both HbA1c and FPG lower than PrediabetesADA. Risk of PrediabetesIEC and PrediabetesADA for incident GH was examined by multivariate Cox proportional hazards model with seven covariates and probability of incident GH was calculated on the basis of it.
Results
PrediabetesIEC was a significant risk for incident GH [adjusted HR 1.91, 95% CI 1.32–2.71] but PrediabetesADA was not [adjusted HR 1.22, 95% CI 0.93–1.61]. The mean (SD) probability of incident GH was 2.3 (4.5)%, 1.0 (2.3)% and 1.0 (2.4)% for PrediabetesIEC, PrediabetesADA−IEC and NGRADA, respectively: the former was significantly larger than the latter two which were not significantly different from each other.
Conclusions
PrediabetesIEC was an independent risk for incident GH.
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Acknowledgements
The authors thank Drs. Hisashi Noma and Mitsuhiko Noda for their constructive comments.
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Kawata, I., Koshi, T., Hirabayashi, K. et al. Prediabetes defined by the International Expert Committee as a risk for development of glomerular hyperfiltration. Acta Diabetol 56, 525–529 (2019). https://doi.org/10.1007/s00592-019-01287-9
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DOI: https://doi.org/10.1007/s00592-019-01287-9